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Organization
SOUTHERN GRACE SERVICES
Active
Organization
SOUTHERN GRACE SERVICES
Active
Other names
Southern Grace - Senior Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY SHAWN ELKINS (EXECUTIVE DIRECTOR)
(601) 602-5411
Entity
Organization
Contact information
Practice address
117 N MAIN ST STE 200, PETAL, MS 39465-2366
(601) 602-5411
(601) 602-5410
Mailing address
117 N MAIN ST STE 200, PETAL, MS 39465-2366
(601) 602-5411
(601) 602-5410
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006952057
—
MS
Enumeration date
02/02/2016
Last updated
09/22/2026
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